Near-patient environmental contamination of an intensive care unit with Vancomycin-resistant Enterococci (VRE) and Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL-E) before and after the introduction of chlorhexidine bathing for patients.
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In the intensive care unit (ICU), prior room contamination by patients with, for example, vancomycin-resistant Enterococci (VRE), and extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-E) is predictive for the acquisition of infections. However, while daily chlorhexidine bathing reduces infection rates due to multidrug-resistant pathogens, the effect of this practice on environmental contamination rates are largely unknown. Surveillance of the healthcare environment is usually only conducted in response to outbreaks along with other infection prevention and control (IPC) investigations and interventions. This is largely due to resource constraints, the transient nature of environmental contamination, low yields from environmental screening, and culture delays, all of which preclude rapid decision making based on these results. In an observational study in a 12-bed adult medical/surgical ICU during non-outbreak periods, we assessed the overall bacterial contamination of near-patient surfaces of occupied beds, including VRE and ESBL-E, before and after the introduction of a chlorhexidine bathing protocol.